point of care artificial intelligence tool for heart failure diagnosis

Conditions: Heart Failure

Summary: abbreviations/acronyms: duo-ef = prediction of ejection fraction (ef) using the eko-duo digital stethoscope algorithm hf = heart failure hfref = heart failure with reduced ejection fraction covid-19 = coronavirus disease 2019 eko duo = digital stethoscope device cmri = cardiac magnetic resonance imaging ecg = electrocardiogram prospective observational study of left ventricular ejection fraction predicted by application of artificial intelligence to single-lead ecg acquired by a digital stethoscope; in the post-covid-19 follow up clinic, in patients presenting with heart failure symptoms in primary care, and in patients attending for echocardiography and cardiac mri.

abbreviations/acronyms: duo-ef = prediction of ejection fraction (ef) using the eko-duo digital stethoscope algorithm hf = heart failure hfref = heart failure with reduced ejection fraction covid-19 = coronavirus disease 2019 eko duo = digital stethoscope device cmri = cardiac magnetic resonance imaging ecg = electrocardiogram aims to demonstrate duo-ef can identify heart failure (hf) with reduced ejection fraction (hfref) post-covid-19 where diagnosis would otherwise be missed/delayed to demonstrate duo-ef can reliably and accurately diagnose new hfref in the primary care setting to further validate duo-ef diagnostic performance at-scale against gold-standard investigations (echocardiography and cardia mri) to measure if duo-ef suggestive of hfref but with normal gold standard investigations predicts future risk of developing hfref methods to demonstrate duo-ef can identify heart failure (hf) with reduced ejection fraction (hfref) post-covid-19 where diagnosis would otherwise be missed/delayed to demonstrate duo-ef can reliably and accurately diagnose new hfref in the primary care setting to further validate duo-ef diagnostic performance at-scale against gold-standard investigations (echocardiography and cardiac magnetic resonance imaging - cmri) to measure if duo-ef suggestive of hfref but with normal gold standard investigations predicts future risk of developing hfref duo-ef prediction of ejection fraction in patients attending covid-19 follow up clinic and comparison with: subsequent duo-ef at time of gold-standard investigation for hf ejection fraction as calculated by gold-standard investigation duo-ef prediction of ejection fraction in patients where their gp suspects new heart failure and comparison with: subsequent duo-ef at time of gold-standard investigation ejection fraction as calculated by gold-standard investigation duo-ef prediction of ejection fraction in unselected patients attending for echocardiography or cardiac mri, comparing duo-ef predicted with gold-standard calculated ejection fraction telephone call follow-up at 24 months for all patients with duo-ef suggestive of hfref but normal gold standard investigations outcome measures area under curve (auc) of duo-ef calibrated for detection of ef below 40%; classification accuracy positive predictive value of duo-ef in covid-19 clinic and gp context based on subsequent gold-standard estimation of ef; negative predictive value of duo-ef in covid-19 follow up cohort; positive predictive value of duo-ef at 24 months in those with negative gold standard investigations qualitative measurement of patient and clinical end user acceptability of eko duo population group 1: patients seen in the covid-19 follow-up clinic (n = 400) group 2: patients seen in primary care with symptoms newly suggestive of heart failure (n = 400) group 3: all-comers to echocardiography departments across imperial college healthcare nhs trust (n = 1,500) group 4: patients undergoing cardiac mri investigation (n = 100)

Eligibility criteria:
inclusion criteria: * attendance at gp with ?hf symptoms * referral from gp or elsewhere for echocardiogram in hospital * age \>18 exclusion criteria: * unable to give informed consent